Synchron CEO on What's Next for Brain Chip Implants

Please welcome to the stage Tom Oxley, CEO of Synchron, for conversation with Bloomberg's Ed Ludlow. OK, good afternoon, everyone. Wake up. We're going to be talking about the brain computer interface. We're literally going to be talking about the merits, benefits and progress of implanting A probe into the human brain. And it's a timely conversation because there is another billionaire backed company doing something similar but slightly different. That made some news this week, which we'll discuss. What I want to do. Tom Oxley, MDPHD, Synchron founder and CEO is get right to this poll. So it's a simple question, would you ever consider receiving a brain chip implant in? In all truth, it's not as simple as that as you're about to hear. So let's vote now and then let's vote again at the end and see where we land. I think that's probably a good exercise based on the conversation we're about to have. Feels like some information is missing from the question. And and I'm being honest, as you know, Bloomberg's Ed Ludlow is honest. Let's start with with BCI brain computer interface. It's a fancy for one of a better expression Silicon Valley term, but it actually means something. So define it for us brain computer interface. So ours is an implantable brain computer interface. So I'll confine it to those that require some type of procedure or surgery that that's the the wave of technology that's coming through now. So the concept is device goes into the brain, into the brain, on the surface of the brain. It creates a stream of information out of the brain. And that stream of information can be used to restore some level of function. So we're going to be looking at a video of how what you call the stentrode makes its way into the human skull and brain. So just explain what we're seeing and looking at here. So this is a live X-ray of one of our patients who had an implant. So the catheter you can see, it's sliding up on the inside, inside a blood vessel on the surface of the brain. And it then opens up like a flower when it's delivered out of the catheter. And then it's resting against the surface of the brain and it's got an electronic circuit and sensors or can record local brain activity and then a telecommunication system to wirelessly send the information out of the body. The people who consider these are in this first application those who have lost the ability to move. So paralysis or motor impairment, there are a number of of companies as we touched on that that are looking at the the method of of implant in the human brain. Your delivery system is unique and and and correct me if I get the basics wrong, but you're basically getting the probe there through a stent which goes through the jugular in the neck. It is not without risk, but it's less risky than what we will talk about which is drilling a hole in the skull and and placing a cap on top. Yeah I think part of it is around what the what risks are known and we've we know what the risks of catheter based stent based deliveries are because there's been decades of use with cardiac delivered technology. So we've we've borrowed that which is now scaled to millions of procedures a year applied in the heart and taken that over to the brain. So it's not without risk, but yes, it's not open brain surgery, not open brain surgery, but it's possible. I think you've just hit patient #10. I mean you and I were chatting backstage. I, when I was a very young child had open heart surgery twice I had a hole in the heart, which some in this audience may may also have had. And in those days it was fixed by applying a Gore Tex patch. And of course modern medicine has moved on and and many complicated and straightforward heart procedures are done via keyhole for for one of the better expression. So but you've only done this method 10 times so far. So what I'm trying to outline is, well, we've made progress but 10 isn't that many people it seems. Yeah, especially given the size of the problem. There's 8 million people in the US and you know any of us in the room could have a stroke or develop Ms. or develop ALSA condition that stops your body from working. We're all at risk of that. And neurology, I'm a neurologist, we've traditionally it's been the field in medicine where there hasn't been many treatment options. And so neurotechnology is having this moment now in medicine where it's becoming kind of the final frontier of medicine and a lot of excitement. But the challenge with cracking the skull and delivering technologies that way is that the infrastructure is not set up for scale for applications of that technology. Cardiology has shown over decades that you can now deliver millions of stencil pacemakers a year that so there's now we're translating what's known from cardiac into neuro. And I think we're entering a period where the treatment opportunities for neuro delivered through a catheter into the brain are going to become vast and it's I think we're going to enter a very large growth phase. Could we please show the the poll results as they stand now and as I said we'll revisit it later in the session and and I think that's that's pretty obvious isn't it 52% of respondents those of you here want more information so let's let's give them more information. The comparison is Neuralink and I promise I'll give you the the forum to to to to talk about your technology bit. Neuralink is basically you make a hole in the skull. Neuralink is Elon Musk's brain implant company, just to let you know and it has 1000 electrodes, very thin tiny wires that that move into the brain. This week they they disclosed that that it wasn't quite working properly. But one issue is that the brain is moves inside the human skull. Your system does not have the same problem. This is well timed because essentially the stentrode merges or interacts with the blood vessels at the cellular level. Take it from that So implantable BCI in the academic domain for 20 years first human implant Lee Hochberg and Brown University, Harvard back in 2006. Similar principle to what Neuralink is doing. The challenge that has not been solved yet is if you have the brain which is like a Jelly sitting inside a rigid box, if you connect the device to the rigid bone and then the brain moves, that's a challenge. So that's, you know, it's their first subject. They're just getting started. They're just entering into clinical, so they're going to learn a lot. They've obviously got the spotlight on what they're doing. So every little thing is amplified for them. Does that help you? Uralink is very present in the news cycle, right. Does that help what you're trying to achieve? The there is a lot of capital coming into to bring computer interface now and I think you know Elon Musk dedicating his part of his time to that I think is a sign that people that there's a big market there's a big problem that there's an interesting application that can have a huge impact on patients lives. So yes it's it's a great time for neurotechnology for for me when I was researching and preparing to talk to you I I was probably surprised by the the rate of progress you know actually 10 people with quite a lot of patients. When you consider the the regulatory road map, where are you with with getting regulatory approvals to make it a commonplace market technology. Yeah. So this market is going to be implantable brain computer interface for paralysis implantable devices that need a class three approval from FDA typically 7 to 10 year from first implant to FDA approval. So Neurolink have just done their first subject. We did our first in 2019. So we're five years in two trials in yes 10 patients and now we're looking at towards moving towards a larger study. So that's kind of gives a sense of of and then there's another four players entering into the market all slightly different approaches into the brain. In the first instance the the paralysis use case case study deeply difficult but but the the, the goal is to allow the patient to use the thoughts in in much the same way that everyone gathered here uses their fingers to to basically interact with a touchscreen. Is that a fair summation? 10% of your brain is your motor cortex, which is your Control Center for all of the muscles in your body. I'm using it to control my mouth, my vocal cords, my hands. So if you have a condition that disrupts your body's ability to move, you can go into the brain to the source of the control signal. And so it's really going to the heart of what? How you express yourself. So you talked about autonomy. So if you have a range of conditions that impair your ability to move, we take it for granted. But you therefore can't express yourself on a range of levels. So the the the smartphone right now is a very easy technology to control via Bluetooth, and you can use pretty rudimentary signals out of the brain to control the phone. So that's where it's going to start. So we've been working with Apple. There's a Bluetooth input that lets you navigate through iOS without having to to use your fingers. What's the road map from here? You know, it's a very specific use case, but you share this big picture goal with Neuralink. You both use the word autonomy, but you could extrapolate out and say, well you and I might have this conversation in five, 1020 years time and a different use case you may have developed. So what are you working on future iteration? So BC is very new, but we're looking at the technology that's been available through traditional open brain surgery, deep brain stimulation, brain monitoring, all of those applications are very effective and there's a large patient population to treat. But deep brain stimulation only about 10,000 procedures done a year. So there's proof points in open brace, open brain surgical industry that it's very effective. So what we're seeing is if we can take that technology and deliver it in the Cath lab, then there's going to be a potential huge growth like what we saw with Interventional cardiology over the last several decades. You you talked about how Neuralink and particularly Elon Musk's backing of an involvement with them has brought capital to your industry. I I think I'm right in saying you last raised money in in 2022. You count Jeff Bezos's adventure or family arm as one of your backers the Gates Foundation as well. Why have you not raised more money since 2022? I go to work every week and I write about how Elon Musk is raising money for something. Haven't been writing that about you and neither is Sarah McBride who by the way highly recommend you follow Sarah. Just I'm really deep body of reporting on both neural Link and you actually back 2022. Medical devices take time. We're being very careful with that capital that we're allocating. If our burn rate goes up too high while we're on an FDA timeline, you can throw a huge amount of capital. But if the FDA is needing long term safety data to get market approval, there's no point in growing too fast. So we're just taking it step by step and we're you know we're we're for the size of company, we're at what size we're at 78 people now for the stage of where we're at that's you know medium to large. So Neuralinks a bit of an outlier in terms of capital expenditure in this, in this space. The focus is that the cathode or or stent delivery system is scalable. Do you have any sense of the demand for that technology and methodology that you are capped by the regulatory process at patient 10, but were you able to scale, do you see roll out in healthcare systems in America? That's where we are we we do. So if you need to get open brain surgery, you have to go to an academic neurosurgical centre. If you want to get a stent, you can go down to a community level, secondary level hospital. So there's thousands of people who can do that versus hundreds who can do open procedures. So that plus the fact that the brain is the largest cause of disability, it's just that treatment options have been so low, so huge gap between the market need and what technology is deliverable and now you have an infrastructure that's ready to deploy at scale. So we're just moving into that space and our whole intellectual property position is read, write with technology, telecommunication technology in the brain that can be delivered through a catheter. Can we talk a bit then about patient 10? What evidence of progress are you seeing in that patient and and and what literally granular information can you give us about how you're moving forward with that patient. So patient 10 has ALS. He can't move his arms. He can actually still speak. And people will say, why would you get a brain computer interface if you can still talk? And he tells me the story that the phone's sitting there and it rings. You can't use Siri to answer the phone. So there's a whole, there are a whole bunch of pain points where you need to hit a button just to do little things. So we're identifying what all those little pain points are. The system turns on. So he can now actually use his voice and the system to engage in a range of activities where he would otherwise need his caregiver or someone in his family to come and engage. So the whole that's what autonomy is. I mean you know the feeling when you've lost your phone and you're like everything stops until you find I haven't let go of it since we came on stage. There's no treatment for paralysis. So if your body stops working there's there's nothing that you can do. So the people who have, the people who are facing that loss of autonomy are looking for options and from from for them BC is a very exciting potential treatment. In the last two minutes we have left make the case to the audience, not just here but around the world on why your technology is the way forward in addressing this issue and then we'll revisit the poll. I think what I'd say is brain implants can be highly effective, but until we figure out how to make them deliverable at scale, it's never going to reach a mass market. So we've seen that cardiology can deliver on that and now that's going to move over to the brain. This is no reflection of you. But actually in that exact moment, the number of people who wanted more information has gone up by two percentage points and now down. So I think we're on the fence and maybe a bit of latency here. I wouldn't want a brain implant unless I needed it either. But this is, this is not, this is not Black Mirror technology. This is to help people. It's if your body's not working, that's when you might contemplate it. There's a very serious goal, right? Let's stick with the 8 million with paralysis in this country. You are a neurologist by background and and closely associated with Mount Sinai. What other expertise and competence have you guys got at Synchron that you feel is sort of world leading in its field? We have pulled together a team that have expertise in electronics and in Class 3 implantable technologies and signal processing. Is it competitive given that there are several players all seeking similar outcome? It is, yeah, it is competitive. And how do you stay competitive from a talent perspective? We stay on the East Coast. Well, that went down surprisingly well in this room. I just very quickly explained the benefit of that New York City is Control Labs got picked up by meta. There's lots of interesting software engineering, neural engineering talent around the computational side of what we're doing. And there's this good medtech talent, you know, more in Minneapolis, but there's lots of talent in New York. And other than that, a lot of the BCI focus has been around here. Tom Oxley, MDPHD and and founder and CEO of Synchron. That was a conversation I wanted had for a long time and I think the audience greatly appreciated as well. Thank you very much.